Modified stoppa approach for complex acetabular defects reconstruction with bone autograft and acetabular augmentation
Keywords:
developmental dysplasia of the hip, Stoppa approach, acetabular defects, bone autograft.Abstract
Introduction: Developmental dysplasia of the hip (DDH) is the cause of 2.6-9.1 % of all total hip prostheses implanted at any age and constitutes a challenge in revision surgeries. Objective: To present a case of severe acetabular dysplasia managed by the Stoppa-type approach.
The Case: We report a case of a 26-year-old male patient with DDH initially treated with total hip replacement and then diagnosed with aseptic loosening (Paprosky 3A). Using a modified Stoppa approach; acetabular augmentation and bone autograft attached with endopelvic reconstruction plates were performed. Two years after the procedure our patient is asymptomatic, has no restrictions on his daily living activities, and is very satisfied with the result.
Conclusions: The Stoppa approach was very useful for the endopelvic reconstruction of the acetabular roof, so it may be an option to treat severe acetabular defects. Level of evidence: IV.
Downloads
References
Moraleda L, Albiñana J, Salcedo M, Gonzalez G. [Dysplasia in the development of the hip]. Rev Esp Cir Ortop Traumatol. 2013;57(1):67-77. DOI: https://doi.org/10.1016/j.recot.2012.10.005
Street MWJ, Howard LC, Neufeld ME, Masri BA. Vascular injuries during hip and knee replacement. Orthop Clin North Am. 2022;53(1):1-12. DOI: https://doi.org/10.1016/j.ocl.2021.08.009
Aqil A, Shah N. Diagnosis of the failed total hip replacement. J Clin Orthop Trauma. 2020;11(1):2-8. DOI: https://doi.org/10.1016%2Fj.jcot.2019.11.003
Cherian JJ, Jauregui JJ, Banerjee S, Pierce T, Mont MA. What Host Factors Affect Aseptic Loosening After THA and TKA? Clin Orthop Relat Res. 2015;473(8):2700-9. DOI: https://doi.org/10.1007%2Fs11999-015-4220-2
Paprosky WG, Perona PG, Lawrence JM. Acetabular defect classification and surgical reconstruction in revision arthroplasty. A 6-year follow-up evaluation. J Arthroplasty. 1994;9(1):33-44. DOI: https://doi.org/10.1016/0883-5403(94)90135-x
Kim HY, Yang DS, Park CK, Choy WS. Modified Stoppa approach for surgical treatment of acetabular fracture. Clin Orthop Surg. 2015;7(1):29-38. DOI: https://doi.org/10.4055/cios.2015.7.1.29 .
Murcia A, Ferrero F, Lax R, Fernández M. Stoppa approach for intrapelvic damage control and reconstruction of complex acetabular defects with intra-pelvic socket migration: A case report. Int J Surg Case Rep. 2016;25:143-8. DOI: https://doi.org/10.1016/j.ijscr.2016.06.022 .
Ciriviri J, Nestorovski Z, Talevski D, Vranishkovski T, Kostov H. Treatment of acetabular defects with porous metal augments in revision hip surgery. Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2019;40(2):33-9. DOI: https://doi.org/10.2478/prilozi-2019-0012
Del Gaizo DJ, Kancherla V, Sporer SM, Paprosky WG. Tantalum augments for Paprosky IIIA defects remain stable at midterm follow-up. Clin Orthop Relat Res. 2012;470(2):395-401. doi: https://doi.org/10.1007/s11999-011-2170-x
Jenkins DR, Odland AN, Sierra RJ, Hanssen AD, Lewallen DG. Minimum five-year outcomes with porous tantalum acetabular cup and augment construct in complex revision total hip arthroplasty. J Bone Joint Surg Am. 2017;99(10):e49. DOI: https://doi.org/10.2106/jbjs.16.00125
